Is andropause the next big focus for hormonal health?

Menopause is making headlines but have you heard of andropause? The Global Wellness Institute (GWI) and their Hormonal Wellness Initiative predicts that andropause "will be bigger (and badder) than menopause" as we head through the second half of 2023.

They said: "2023 saw the UK government refuse to allow menopausal women protected status in the workplace via equality legislation. The reason? It could lead to discrimination against men. Many of the arguments for managing menopause as an occupational issue centre around the cost to organisations of replacing women for whom the workplace is no longer friendly. The exodus of men from the workplace is, by any measure, currently more costly than that of their female colleagues. Add to this the significant health effects, both physical and mental, of andropause and a 2023 trend is born."

The big takeaway from the GWI is that 2023 will see us look at hormonal change as a non-binary issue, requiring a greater understanding of hormone therapies and the impact of changed levels in all.

What is andropause?

The National Institutes of Health (NIH) say:

"'andropause' is defined as a syndrome associated with a decrease in sexual satisfaction or a decline in a feeling of general well-being with low levels of testosterone in older men."

This androgen deficiency in older men is often referred to as the 'male menopause', which the NHS describes as "an unhelpful term sometimes used in the media". They describe the term as "misleading because it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This is not true."

They note that testosterone levels do decline as men age, at a rate of about 1% a year from around the age of 30 to 40, but that in itself is unlikely to present an issue, as opposed to testosterone deficiency, which can occasionally develop in later life.

The British Association of Urological Surgeons says the preferred term is Androgen Deficiency in the Ageing Male (ADAM).

What are andropause symptoms?

• Hot flushes, sweating, insomnia and nervousness
• Anxiety, irritability, poor sleep, constant tiredness, poor short-term memory and low self-esteem
• Decreased physical energy and decreased muscle strength
• Reduced sex drive and function
• Abdominal weight gain, loss of body hair, diminished muscle mass and loss of height
• Increased LDL cholesterol, increased total body fat, osteoporosis and reduction in the red blood cells in the blood

What causes andropause?

Physically, andropause is caused by low testosterone, and the NIH says:

"True andropause exists only in those men who have lost testicular function, due to diseases or accidents, or in those with advanced prostate cancer subjected to surgical or medical castration."

However, they also notes that regarding more general hormonal changes in men as they get older:

"The rate of decline in testosterone levels varies in different individuals and is affected by chronic disease, such as obesity, illness, serious emotional stress, and medications; and this decline can be decelerated by management of health and lifestyle factors."

So, is this something we need to think about? The GWI's position is a suggestion that we need to be generally more aware of the impact of hormonal change on both men and women, and understand that whoever it's impacting individually, it actually affects us all. Do you agree?